NPI | 1881461556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61508228) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: WA AP61508228) |
Enumeration Date | 2023-12-04 |
Last Update Date | 2024-01-25 |